IdentityYour surname (as it appears in your passport)(Required)Given name(s) (as it appears in your passport)(Required)Other surname you have been known byOther given name(s) you have been known byType of namePlease selectBirthMarriedNicknameOtherTitle(Required)Please selectMrMrsMsMissDrGender(Required)Please selectMaleFemaleX (gender diverse)Relationship status(Required)Please selectSingleMarriedDe FactoDivorcedWidowedSeparatedNationality(Required)Please selectAfghanAlbanianAlgerianAmericanAmerican SamoanAndorranAngolanAnguillanAntarcticAntiguan and BarbudanArgentineArmenianArubanAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBasothoBelarusianBelgianBelizeanBenineseBermudianBhutaneseBissau-GuineanBolivianBonaireanBosnian and HerzegovinianBotswananBouvet IslanderBrazilianBritishBritish Indian Ocean Territory nationalBritish Virgin IslanderBruneianBulgarianBurkinabeBurmeseBurundianCabo VerdeanCambodianCameroonianCanadianCaymanianCentral AfricanChadianChileanChineseChristmas IslanderCocos IslanderColombianComorianCongolese (Democratic Republic of the Congo)Congolese (Republic of the Congo)Cook IslanderCosta RicanCroatianCubanCuraçaoanCypriotCzechDanishDjiboutianDominican (Dominica)Dominican (Dominican Republic)DutchEcuadorianEgyptianEmiratiEnglish (if you prefer for UK subset, though British is correct)Equatorial GuineanEritreanEstonianEswatini nationalEthiopianFalkland IslanderFaroeseFijianFilipinoFinnishFrenchFrench GuianeseFrench PolynesianFrench Southern Territories nationalGaboneseGambianGeorgianGermanGhanaianGibraltarianGreekGreenlandicGrenadianGuadeloupeanGuamanianGuatemalanGuernsey nationalGuineanGuyaneseHaitianHeard IslanderHonduranHongkongerHungarianIcelanderIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJersey nationalJordanianKazakhKenyanKiribati nationalKittitian and NevisianKorean (North Korean)Korean (South Korean)KuwaitiKyrgyzLaoLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgishMacao nationalMacedonian (North Macedonian)MalagasyMalawianMalaysianMaldivianMalianMalteseManxMarshalleseMartinicanMauritanianMauritianMahoranMexicanMicronesianMoldovanMonégasqueMongolianMontenegrinMontserratianMoroccanMozambicanNamibianNauruanNepaliNew CaledonianNew ZealanderNicaraguanNigerienNigerianNiueanNorfolk IslanderNorthern MariananNorwegianOmaniPakistaniPalauanPalestinianPanamanianPapua New GuineanParaguayanPeruvianPitcairnerPolishPortuguesePuerto RicanQatariRomanianRussianRwandanRéunioneseSaint Barthélemy nationalSaint HelenianSaint LucianSaint-MartinoisSaint-Pierrais and MiquelonnaisSaint VincentianSalvadoranSamoanSan MarineseSahrawiSão ToméanSaudiSenegaleseSerbianSeychelloisSierra LeoneanSingaporeanSint MaartenerSlovakSlovenianSolomon IslanderSomaliSouth AfricanSouth GeorgianSouth SudaneseSpanishSri LankanSudaneseSurinameseSvalbardianSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTimoreseTogoleseTokelauanTonganTrinidadian and TobagonianTunisianTurkishTurkmenTurks and Caicos IslanderTuvaluanUS Minor Outlying Islands nationalUS Virgin IslanderUgandanUkrainianUruguayanUzbekVanuatuan (Ni-Vanuatu)Vatican nationalVenezuelanVietnameseWallisian or FutunanYemeniZambianZimbabweanOTHER (not listed)Your nationality(Required)Date of birth(Required) DD slash MM slash YYYY Country of birth(Required)Please selectAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsTown of Birth(Required)State or Province of BirthDo you have a national ID number?(Required)Please selectYesNoNational ID number(Required)Country of issue(Required)Please selectAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsSection BreakContact DetailsCellphone number(Required)Landline number (if applicable)Your Email Address(Required) Email Address Confirm Email Address Residential address(Required) Street Address Address Line 2 City ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Passport detailsPassport number(Required)Country of issue(Required)Please selectAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsIssue Date(Required) DD slash MM slash YYYY Expiry Date(Required) DD slash MM slash YYYY Other passport(s) if applicableAdd additional passport information here Passport number Country of issue Issue Date Expiry Date Actions Edit Delete There are no Entries. Add another passport Maximum number of entries reached. Immigration Status - in New ZealandImmigration New Zealand Client NumberNZeTA numberAre you lawfully in New Zealand?(Required)Please selectYesNoCurrent Visa Category(Required)Please selectVisitorStudentAEWVWHVPBWVPSWVRVPRVOtherCurrent Visa issue date(Required) DD slash MM slash YYYY Current Visa expiry date(Required) DD slash MM slash YYYY What was you last address before you came to New Zealand?(Required)Immigration Status - outside New ZealandHave you previously visited New Zealand?(Required)Please selectYesNoEnter your Immigration New Zealand client or NZeTA numberLast visa held(Required)Please selectVisitorStudentAEWVWHVPBWVPSWVRVPRVOtherDate of last entry to New Zealand(Required) DD slash MM slash YYYY Date of last departure from New Zealand(Required) DD slash MM slash YYYY Are you in a country that is not your country of citizenship?(Required)Please selectYesNoWhat type of visa do you hold?(Required)When does your visa expire?(Required) DD slash MM slash YYYY HealthDo you have tuberculosis?(Required)Please selectYesNoDo you require renal dialysis, hospital care or residential care?(Required)Please selectYesNoHave you been idenitfied as someone who needs special education services?(Required)Please selectYesNoHave you ever had a blood or blood product transfusion?(Required)Please selectYesNoHave you ever used intravenous drugs?(Required)Please selectYesNoHave you ever participated in, or been exposed to any activity which may have exposed you to a serious infectious disease auch as HIV or hepatitis B or C?(Required)Please selectYesNoAre you pregnant?(Required)Please selectYesNoWhen are you due?(Required) DD slash MM slash YYYY Have you previously provided Immigration New Zealand with a General Medical Exam?(Required)Please selectYesNoWhat was the date you had your medical exam?(Required) DD slash MM slash YYYY Enter your eMedical Reference Number(Required)Have you previously provided Immigration New Zealand with a chest X-ray?(Required)Please selectYesNoWhat was the date you had your medical exam?(Required) DD slash MM slash YYYY Enter your eMedical Reference Number(Required)Have you been outside New Zealand for more than 6 months since you provided your chest X-ray?(Required)Please selectYesNoWhat countries have you been in for more than 3 months?(Required)Has Immigration New Zealand asked you to provide more information about your health for a previous application?(Required)Please selectYesNoPlease provide details(Required)CharacterHave you ever been charged for any offence in any country?(Required)Please selectYesNoWhat was the offence?(Required)What was the maximum prison sentence a court could have given you?(Required)What was the country or were the countries?(Required)Are you currently under investigation for any offence in any country?(Required)Please selectYesNoWhat is the offence you are under investigation for?(Required)What is the maximum prison sentence you could be liable for?(Required)What is the country or are the countries?(Required)Have you ever been convicted of an offence for which you could have been sentenced to 3 months or more of imprisonment?(Required)Please selectYesNoWhat were you convicted of?(Required)What was the country or were the countries?(Required)What was your sentence?(Required)What was the maximum prison sentence a court could have given you?(Required)What was the date of your conviction?(Required) DD slash MM slash YYYY Have you ever had a visa declined?(Required)Please selectYesNoBy which country(ies)?What class of visa(s) were you applying for?(Required)What was the date of the decision(s) to decline your visa(s)?(Required) DD slash MM slash YYYY Have you ever been refused entry into any country?(Required)Please selectYesNoBy which country(ies)?(Required)What was the date you were refused entry?(Required) DD slash MM slash YYYY Have you ever been deported, expelled or removed from any country?(Required)Please selectYesNoBy which country(ies)?(Required)What was the date on which you were deported?(Required) DD slash MM slash YYYY Have you provided Immigration New Zealand with a Police Certificate from your country of nationality or countries of nationality with a previous application?(Required)Please selectYesNoWhat was/were the date(s) of issue of the Police Certificate(s)?(Required) DD slash MM slash YYYY Have you lived in your principal country of nationality?(Required)Please selectYesNoHave you lived in any other countries for which you hold nationality?(Required)Please selectYesNoPlease list the country or countriesHave you lived in any country other than your country of nationality for 5 years or more since your 17th Birthday?(Required)Please selectYesNoWhat was the country or were the countries?(Required)Have you provided Police Certificates to Immigration New Zealand from these countries with a previous application?(Required)Please selectYesNoWhat were the dates of issue of the Police Certificates?(Required) DD slash MM slash YYYY Have you lived in any country other than your country of nationality for 12 months or more since your 17th Birthday?(Required)Please selectYesNoWhat was the country or were the countries?(Required)Have you provided Police Certificates to Immigration New Zealand from these countries with a previous application?(Required)Please selectYesNoWhat were the dates of issue of the Police Certificates?(Required) DD slash MM slash YYYY Is this a Resident Visa application?(Required)Please selectYesNoHave you sat an IELTS, TOEFL iBT, PTE Academic, FCE or OET test?(Required)Please selectYesNoWhat was the date of your test?(Required) DD slash MM slash YYYY What was your overall band score?(Required)
